This Fast Track proposal develops a computerized Comprehensive Patient Management System (CPMS) to enhance and monitor patient assessment, physician process, and the physician-patient interaction. CPMS components include a Patient Carrel, Physician Workstation and Server/Database. A flexible, scaleable structure will support developing and refining the clinical strategy without re-programming. Phase I Aims are to: 1) Produce a prototype of the patient assessment module, which directly captures patient input regarding symptoms and psychosocial variables, identifies provisional problems, and measures quality of life. The interface will be simple and intuitive and use touch screens to eliminate use of keyboards or mice. CPMS "intelligently" branches through questionsets, abbreviating the process and maximizing relevance to patients. Data will be presented in problem- oriented, clinical report format, improving physician efficiency and motivating participation. 2) Develop pilot applications for gastroesophageal reflux and assessment of psychosocial status. An expert panel and patient focus groups (FG) will critique questions. 3) Critically test accuracy identifying symptoms and provisional problems. Patient FG will undergo CPMS evaluation and examination by physician FG members who have been given the CPMS report for review. Primary Phase I milestones are patient acceptance of the CPMS assessment process and physician critiques of clinical accuracy and utility. PROPOSED COMMERCIAL APPLICATION: This software system is designed to enhance patient assessment and physician process and capture process and outcome measures. Once feasibility has been established, commercial value will stem from use as an outcome tool in controlled trials and as a mechanism to enhance and measure treatment process and patient outcomes in practice settings.